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学生与卵子:以基因换取学费过程中自主权与知情同意权的缺失

The student and the ovum: the lack of autonomy and informed consent in trading genes for tuition.

作者信息

Papadimos Thomas J, Papadimos Alexa T

机构信息

Department of Anesthesiology, Medical College of Ohio, 3000 Arlington Avenue, Toledo, Ohio 43614, USA.

出版信息

Reprod Biol Endocrinol. 2004 Jul 12;2:56. doi: 10.1186/1477-7827-2-56.

Abstract

Rising tuition costs have forced university students to become creative in finding ways to fund their education. Some female university students have decided that ova donation may be an acceptable alternative in which to pay for their tuition. This alternative presents itself because of the insufficient number of ova available for assisted reproduction and emerging stem cell technologies. Young female university students are encouraged by Internet sources and respectable electronic and print media to donate their ova in the cause of assisted reproduction for monetary compensation. While university students generally exhibit autonomy, the constraining influence of their financial predicament compromises the elements of informed consent (voluntariness, competence, capacity, understanding, and disclosure) as to their making an autonomous decision in regard to egg donation. Thus, any moral possibility of giving informed consent is negated. Informed consent can only occur through autonomy. A female university student in need of financial resources to pay for her education cannot make an autonomous choice to trade her genes for tuition. Donated ova are not only needed for assisted reproduction, but for stem cell technologies. While the long-term health of women who donate their ova is of concern (a potential risk of cancer after long term use of ovulation induction), of equal concern is the possibility of a growth in the trade of ova targeting third world and Eastern European women where the precedence for autonomy and informed consent is not well established.

摘要

不断上涨的学费迫使大学生们在寻找资助学业的方式上变得富有创造性。一些女大学生认为卵子捐赠可能是一种可接受的支付学费的选择。这种选择之所以出现,是因为用于辅助生殖和新兴干细胞技术的卵子数量不足。网络资源以及受尊敬的电子和平面媒体鼓励年轻的女大学生为了获得金钱补偿而在辅助生殖事业中捐赠卵子。虽然大学生总体上表现出自主性,但她们经济困境的限制影响损害了她们在卵子捐赠问题上做出自主决定时知情同意的要素(自愿性、能力、行为能力、理解和披露)。因此,做出知情同意的任何道德可能性都被否定了。知情同意只能通过自主性来实现。一名需要资金支付学费的女大学生无法自主选择用自己的基因换取学费。捐赠的卵子不仅用于辅助生殖,还用于干细胞技术。虽然捐赠卵子的女性的长期健康令人担忧(长期使用促排卵药物后有患癌症的潜在风险),但同样令人担忧的是,针对第三世界和东欧女性的卵子交易可能会增加,而在这些地区,自主性和知情同意的优先地位尚未确立。

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